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  1. 44 Polish Journal of Surgery

  2. 1 Acta Biochimica Polonica

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  2. 8 2015

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  4. 6 2013

  5. 8 2012

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  1. 45 Dziki A.

  2. 22 Dziki Ł.

  3. 18 Mik M.

  4. 14 Majsterek I.

  5. 12 Sygut A.

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1
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Retrospective analysis of local recurrence rate in breast cancer patients treated at the department of surgical oncology in Łódź between 2009 and 2013

100%
Morawiec J., Dziki A., Morawiec Z., Kołacińska A.
Polish Journal of Surgery
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2015
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vol. 86
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issue 2
77-81
EN
The aim of the study was to analyze clinicopathological features in breast cancer patients with local recurrence (LR). Material and methods. A retrospective analysis of database of breast cancer patients operated on in the Department of Surgical Oncology in Łódź from 2 January 2009 to 30 June 2013, identified 1080 women with primary breast cancer and 11 patients with LR. Results. LR rate was 0.23% per year. True recurrence (TR) occurred more frequently in patients with luminal B molecular subtype, in HER-2 positive and in triple-negative subgroups. In one patient with luminal -A subtype new primary (triple negative) occurred. TR were noted predominantly in patients with axillary lymph nodes metastases and with luminal B subtype who did not receive adjuvant chemotherapy but were given only endocrine therapy. LR were observed more frequently in patients who did not receive adjuvant radiotherapy or this treatment was delayed. Minimal surgical margins in postoperative specimens measured by pathologist were 4-25 mm, mean 9.5 mm. Conclusions. The LR rate in patients operated on breast cancer in the Department of Surgical Oncology between 2009 and 2013 was low. TR was diagnosed in patients with non- luminal A breast cancer despite wide surgical margins, especially if the patients did not receive optimal adjuvant systemic treatment or radiotherapy was delayed or omitted. Complete cancer excision followed by an immediate implementation of optimal adjuvant treatment seems to be crucial especially in patients with poor tumor biology.
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Foreign bodies in the rectum – an unusual surgical problem

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Buczyński J., Langner E., Dziki A.
Polish Journal of Surgery
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2012
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vol. 84
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issue 9
454-456
EN
A foreign body in the rectum is not a very common emergency case in surgical practice, of various etiology. In the years 2003-2011, 8 people were hospitalised in the Clinic of General and Colorectal Surgery due to a foreign body in the rectum. All the patients were male. All of them were qualified for foreign body removal in a surgical suite, under general anaesthesia due to a potential need for expanding the scope of the procedure. In all situations attempts were made at removing the object through the anus, which proved successful in 7 cases, without complications.In one case the scope of the procedure needed to be expanded with laparotomy and sigmoidotomy, through which the foreign body was removed. This procedure was also carried out with no complications.
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Local Antibiotic Therapy in Rectal Cancer Surgery

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Morawiec Z., Pawlak M., Kołacińska A., Dziki A.
Polish Journal of Surgery
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2012
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vol. 84
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issue 12
613-617
EN
Infectious complications and their consequences are still key issues in rectal cancer surgery. Currently, intravenous antibiotic administration is a recognized method for lowering the rate of these complications. The aim of the study was to assess the efficacy of complementary application of a gentamicin-impregnated sponge in the perineal wound or in the vicinity of intestinal anastomosis after abdominoperineal resection or low anterior resection. Material and methods. 112 patients with primary rectal cancer were enrolled in this study. 42 patients were treated with a gentamicin sponge and drainage (group A) and 70 individuals were treated with drainage alone (group B). In the aforementioned groups a routine short-term regimen of antibiotic prophylaxis was used. We applied gentamicin-impregnated sponges in 27 patients in whom anterior resection was performed and in 15 patients from the abdominoperineal resection group (64% and 36%, respectively). In the control group, 44 anterior resections and 26 abdominoperineal resections were carried out (63% and 37%, respectively). Results. We did not observe statistically significant differences in the incidence of suppurative complications (intraabdominal abscess, perineal wound infection): 4 cases (9.52%) in group A and 9 (12.58%) in group B and anastomotic leakage with clinical manifestation after low anterior resection: 1 case (3.7%) in group A and 2 (4.5%) in group B. Postoperative fever of unknown origin was noted more often in group B: 23 patients (32.8%) versus 10 patients (23.8%) in group A and this difference was statistically significant (p<0.05). Hospitalization after surgery was also significantly longer in group B (9-37 days, median 11 days) as compared with group A (8-26 days, median 13 days) (p<0.05). Conclusions. Local antibiotic therapy in rectal cancer surgery lowered the incidence of postoperative fever of unknown origin and permitted shorter hospitalization after surgery. Local gentamicin application in rectal cancer surgery did not change significantly the rate of infectious complications.
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The Role of the XPF Gene Polymorphism (Xrcc4) Ser835ser in the Risk of Malignant Transformation of Cells in the Colorectal Cancer

100%
Kabziński J., Majsterek I., Dziki A., Mik M.
Polish Journal of Surgery
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2015
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vol. 87
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issue 2
83-85
EN
Participation of DNA repair systems in the pathogenesis of cancer has been a suspected phenomenon for a long time. Decreased efficiency in DNA repair translates to their ability to fix and consequently leads to mutations and the process of carcinogenesis. Linking individual polymorphisms of DNA repair systems with an increased risk of colorectal cancer will allow the classification of patients to high-risk groups and their placement under preventive program. The aim of the study was to determine the effect of XPF gene polymorphism Ser835Ser on increasing the risk of colorectal cancer in the Polish population. Material and methods. as the material blood collected from 146 patients diagnosed with colon cancer was used. The control group consisted of 149 healthy subjects. Genotyping was performed by Taq- Man method. Results. The results indicate that genotype TCC/TCT is associated with an decreased risk of colorectal cancer (OR 0.574; CI 95% 0.335-0.984; p=0.043). Conclusions. Based on these results, we conclude that the XPF gene polymorphism Ser835Ser may be associated with a decreased risk of colorectal cancer
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Evolution of the Mechanical Suture

100%
Klimczak A., Mirosławska-Kempińska B., Mik M., Dziki A.
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vol. 85
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issue 1
44-46
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Satisfaction with Life after Rectal Prolapse Surgery

100%
Winiarski M., Jóźwiak D., Pusty M., Dziki A.
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vol. 85
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issue 1
29-34
EN
Assessment of satisfaction with life, as a result of comparing own life situation with the individualised personal standards, is an important element for measuring satisfaction with life of the patients suffering from somatic disorders. Literature provides numerous data on satisfaction with life of different groups of patients suffering from somatic disorders. Little space is devoted to the study of the level of satisfaction of patients with rectal prolapse, which is particularly evident in relation to the Polish patient population. The aim of the studywas planned to determine the level of satisfaction with life and its determinants among patients with full-thickness rectal prolapse surgery as well as to assess the improvement of continence after this surgery. Material and methods.The study group consisted of 20 patients operated on for full-thickness rectal prolapse in the Department of General and Colorectal Surgery, Medical University in Lódź. SWLS (Satisfaction with Life Scale) Diener et al. in the Polish adaptation by Juczyński was used to assess global life satisfaction. Assessment of the incontinence severity and the postoperative improvement was made with Jorge and Wexner scale. Results.The average level of global life satisfaction among patients with rectal prolapse surgery is 21.05 (SD = 4.68) and it corresponds to the level of satisfaction of the total population. In the study group, there were no statistically significant differences in the level of global satisfaction with life depending on age, disease recurrence and continence improvement after surgery. The continence after rectal prolapse surgery improved significantly (p< 0.05). Conclusions.The most common consequences of rectal prolapse include incontinence of varying severity. The studies give grounds for considering that a rectal prolapse surgery is an effective method of treatment, being conducive to continence improvement in the study group. Rectal prolapse involves also numerous psychosocial consequences. Due to the complexity of the problem, it appears advisable to undertake further empirical studies with the object of identifying the factors influencing life satisfaction of patients operated on for rectal prolapse.
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Therapeutic Management of Stoma Complications in Selected Patients

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Trzciński R., Kresińska-Kaba T., Dziki A.
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vol. 85
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issue 9
496-504
EN
Stoma complications occur in 21-75% of patients, and 30% of them require redo surgery within 10 years after previous surgical treatment. Medical treatment is successful in most cases with no need for surgery. However, severe stoma complications are the real challenge for medical team and require an individual approach to each patient. The aim of the study was to report stoma patients with severe complications of both ileo- and/or colostomy and present different options of medical treatment. Material and methods. Between March 2005 and April 2007 we treated 8 patients with severe stoma complications at the Department of General and Colorectal Surgery, Medical University of Łódź. There were 4 patients with colostomy, 3 patients with ileostomy and one patient with both ileo- and colostomy. The mean age of patients was 56,7 years (range 30-68 years). Results. In all patients we achieved either complete stoma-related wound healing or we observed substantial progress of wound healing with medical treatment. No patient required surgery for stoma complications. Conclusions. Stoma complications still occur in spite of adherence to rules of stoma care and surgical technique. Most of them can be treated conservatively. Much emphasis is put on close team work comprising doctors and nurses in the treatment of severe stoma complications.
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Higher Apoptosis Index and Proliferation Index in Colonocytes of Patients with Ulcerative Colitis in Remission

100%
Buczyński J., Spychalski M., Ławska-Wierzchniewska A., Dziki A.
Polish Journal of Surgery
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2012
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vol. 84
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issue 6
271-275
EN
Ulcerative colitis (UC) is a inflammatory disease of large bowel. The amount of people suffering from UC increases from year to year. Pathogenesis of this affection is still not entirely clear. Mechanisms of proliferation and apoptosis in colonocytes in the course of the disease are defectedThe aim of the study was to assess the rate of proliferation and intensity of apoptosis in colonocytes in patients with diagnose UC.Material and methods. Colon pathological samples taken from patients with diagnosed ulceraive colitis were examined. Patients were in both clinical and endoscopic remission and were treated with mesalazin. They were patient of Department of General and Colorectal Surgery. To estimate proliferation index dye with monoclonal antibody against Ki67. To determine apoptosis level immunohistochemistry with antybody against Bax was used.Results. Average Ki-67 in the test group was 42,13%, the largest value amounted to 57% and the lowest of 33%. Average value of Bax was 1.47 and ranged between 0-3. High index of bax appear not only in the bottom of the crypt, but also at their outlet.Conclusions. In ulecerative colitis genetic and immunological disturbances occur despite treatment. Mesalazine acting only on certain routes associated with the UC holds the remission, without, however "the molecular remission". Thus, it appears that the results of our research are another proof of the necessary caution in weaning support treatment.
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Resections and Palliative Procedures in Patients Operated on for Colorectal Cancer in Poland in 2005-2008

88%
Klimczak A., Mik M., Dziki Ł., Seroka W., Dziki A.
Polish Journal of Surgery
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2010
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vol. 82
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issue 11
621-625
EN
The aim of the study was analysis of the number of resection and palliative procedures in patients operated on for colorectal cancer in Poland. We also analyzed the number of sphincter-sparing surgery in patients with rectal cancer.Material and methods. Statistical data about surgical procedures performed in patients with colorectal cancer were obtained from the National Institute of Hygiene in Warsaw. The procedures were divided into palliations and resections. The analysis was performed for the period from 2005 to 2008. We analyzed the data including women and men.Results. We observed an increase in the number of resections from 3381 to 3768 (85.6-88% of all treatments) (2005-2008) in patients with colon cancer. A similar regularity was observed in patients who underwent surgery for rectal cancer from 2335 to 2712, respectively (76.4 to 81.4% of all treatments). Similarly, the number of sphincter-sparing surgery over the course of the period has increased from 1502 to 1916 operations.Conclusions. The increase in the percentage of resections and sphincter-sparing surgery may indicate the progress in the earlier detection of colorectal cancer. Another reason for this increase may be improving the level of education of surgeons due to the better availability of workshops and training. However, analysis is based on too short period of time and these conclusions cannot be regarded as final.
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Manual Stitching - the Past and the Present

88%
Klimczak A., Mirosławska-Kempińska B., Biegańska-Płonka M., Mik M., Dziki A.
Polish Journal of Surgery
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2011
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vol. 83
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issue 9
527-530
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Circulating Tumor Cells In Colorectal Cancer*

88%
Kujawski R., Mik M., Przybyłowska-Sygut K., Majsterek I., Dziki A.
Polish Journal of Surgery
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2015
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vol. 87
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issue 5
277-281
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Evaluation Of Antioxidant Defense In Patients With Colorectal Carcinoma

88%
Malinowska K., Mik M., Dziki Ł., Dziki A., Majsterek I.
Polish Journal of Surgery
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2015
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vol. 87
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issue 7
357-361
EN
Cancers are among the most feared diseases of modern civilization. In Poland, colorectal cancer is one of the tumors with the worst prognosis. The ability to cure is primarily dependent on the stage of the disease at the time of diagnosis. The aim of the study was evaluate antioxidant response in patients with colorectal carcinoma. Material and methods. Twenty patients (14 men and 6 women) aged 61.9± 11.1 years with colorectal cancer were included in the study. Twenty healthy subjects (4 men and 16 women) aged 64 ± 15.3 years formed the control group. The erythrocyte activities of antioxidant enzymes, superoxide dismutase (SOD), and glutathione peroxidase (GPx), Results. A significant increase of GPx, and SOD (p < 0.05) were seen in patients compared to healthy controls. Conclusion. The results indicate that the tested antioxidant enzyme activity of glutathione peroxidase and superoxide dismutase is increased in patients diagnosed with colorectal cancer compared to the control group.
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Interdisciplinary Consensus Statement on the Diagnosis and Treatment of Diverticular Disease

88%
Pietrzak A., Mik M., Bartnik W., Dziki A., Krokowicz P.
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vol. 85
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issue 5
294-310
14
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Lack of Association Between the 135G/CRad51Gene Polymorphism and the Risk of Colorectal Cancer Among Polish Population

76%
Mucha B., Przybyłowska-Sygut K., Dziki Ł., Dziki A., Sygut A., Majsterek I.
Polish Journal of Surgery
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2012
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vol. 84
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issue 7
358-362
EN
One of the major causes of carcinogenesis is loss of genome stability. RAD51 in process of homologous recombination (HR) played crucial role in maintenance integrity of genome through initiate of DNA double strand breaks repair. Presence of single nucleotide polymorphism (SNP) in RAD51 gene could change the capacity of DNA repair and altered the response to damaging agents. Research on potential impact of genetic variability on development and progression CRC may contribute to setting new genetic markers or/and determined individual susceptibility to CRC.The aim of the study. This study was designed to evaluate the effect of 135 G/C (rs1801320) RAD51 polymorphism located in the 5' untraslated region on the risk and progression of CRC.Material and methods. The subjects consisted of histologically confirmed colorectal cancer (n = 200) and controls (n = 200) with lack of previous history of cancer. The distribution of genotypes was determined by restriction fragment length polymorphism PCR (RFLP - PCR). Statistical analysis was based on multivariate regression model.Results and conclusion. Our study reveal no significance association of 135 G/C RAD51 polymorphism with occurrence and progression of colorectal cancer.
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The Antioxidative Barier in Patients with Colorectal Cancer

76%
Murlikiewicz Ł., Trzciński R., Sygut A., Rutkowski M., Grzegorczyk K., Dziki A.
Polish Journal of Surgery
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2010
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vol. 82
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issue 6
341-346
EN
Colorectal cancer is still a major medical, economical and public health problem. Pathogenesis of colorectal cancer remains unknown. It is thought both genetic and environmental factors contribute to the etiology and progression of the disease. Reactive oxygen species are known to play a dual role in biological systems they can be either harmful or beneficial. Oxygen-free radicals are important mediators of damage to cell structures, including lipids, proteins and nucleic acids. Radical-related damage to cell structures has been proposed to play a key role in the development of many diseases including cancer.Humans have evolved complex antioxidant strategies to protect cells from oxidation.Total antioxidant capacity (TAC) considers the cumulative action of all the antioxidants present in plasma or other body fluids.The aim of the study was to investigate antioxidant status in patients with colorectal cancer measuring plasma TAC as a tool.Material and methods. The study group comprised 102 patients in different clinical stages operated on for colorectal cancer. To evaluate plasma total antioxidant capacity we used "Total Antioxidant Status Kit" - RandoxResults. Statistical evaluation of results demonstrated significantly lower serum total antioxidant capacity in patients with colorectal cancer, as compared to the healthy control group. We observed increase mean plasma total antioxidant capacity correlating with decrease of clinical disease stage.Conclusions. Colorectal patient have impairment antioxidant barrier. The deterioration of its functioning corresponds with the stage of the disease.
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Contribution of the -173 G/C Polymorphism of Macrophage Migration Inhibitory Factor Gene to the Risk of Inflammatory Bowel Diseases

76%
Przybyłowska K., Mrowicki J., Sygut A., Narbutt P., Dziki Ł., Dziki A., Majsterek I.
Polish Journal of Surgery
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2011
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vol. 83
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issue 2
76-80
EN
Inflammatory bowel disease (IBD) represents a heterogeneous group of chronic disorders characterized by inflammation of gastrointestinal tract, typically with a relapsing and remitting clinical course of unknown etiology. Presumably, IBD develops with response exogenous environmental factors only in persons with genetic predisposition. This predisposition was suggested to be associated with polymorphism and mutations in genes encoding proinflammatory immune system proteins. Enhanced production of macrophage migration inhibitory factor (MIF) was found in patients with inflammatory bowel disease (IBD) and mice with experimental colitis. These results suggest that MIF plays a critical role in etiology of the colitis.The aim of the study was determine whether the MIF -173 G/C gene polymorphism is associated with the susceptibility to inflammatory bowel disease (IBD).Material and methods. A total of 99 IBD patients, including 58 patients with ulcerative colitis (UC) and 41 with Crohn's disease (CD) and 436 healthy controls recruited from the Polish population, were genotyped for MIF polymorphisms. Genotyping of MIF gene polymorphism was performed by a RFLP-PCR.Results. We found an increased risk of UC for the C allele of the MIF-173 G/C polymorphism. The distribution of the genotypes was not significantly different in the CD group compared with the controls.Conclusions. We demonstrated that the C allele is associated with an increased risk for development of UC. This suggests that the G/C polymorphism in the MIF gene promoter may be a potential risk factor for UC in Polish population.
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Association of Polymorphism of Lys589glu Exo1 Gene with the Risk of Colorectal Cancer in the Polish Population

76%
Kabziński J., Przybylowska K., Mik M., Sygut A., Dziki Ł., Dziki A., Majsterek I.
Polish Journal of Surgery
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2015
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vol. 86
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issue 8
370-373
EN
The incidence of colorectal cancer (CRC) is increasing from year to year. Despite intensive research CRC etiology remains unknown. Studies suggest that at the basis of the process of carcinogenesis can lie reduced efficiency of DNA repair mechanisms, often caused by polymorphisms in DNA repair genes. The aim of the study was to determine the relationship between gene polymorphism Lys589Glu of EXO1 gene and modulation of the risk of colorectal cancer in the Polish population. Determination of the molecular basis of carcinogenesis process and predicting increased risk will allow qualifying patients to increased risk group and including them in preventive program. Material and methods. The material used in study was blood collected from 130 patients diagnosed with colorectal cancer. The control group consisted of 135 healthy people. Genotyping was performed by TaqMan method. Results. The results obtained indicate that the genotype Lys/Glu is associated with an increased risk of colorectal cancer (OR 1.811, 95% Cl 1.031-3.181, p = 0.038). Conclusion. On the basis of these results, we conclude that Exo1 gene polymorphism Lys589Glu may be associated with an increased risk of colorectal cancer.
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Anterior overlapping sphincteroplasty – who benefits from the surgery?

76%
Mik M., Rośniak K., Narbutt P., Dziki Ł., Tchórzewski M., Trzciński R., Dziki A.
Polish Journal of Surgery
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2015
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vol. 86
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issue 1
33-38
EN
The aim of the study was to identify clinical factors which could influence the results of overlapping sphincteroplasty. Material and methods. Between 2003-2009 the group of 78 incontinent patients (59 women, mean age of 61±13 years), was operated on with anterior overlapping anal sphincteroplasty. Only patients with severe incontinence (>16 pts in Wexner scale) were included. Before surgery and in follow-up period anorectal ultrasound, manometry and incontinence assessment were performed and in follow-up period patients additionally fulfilled survey. The study was prospective. Follow up period was more than 36 months. Results. In survey the excellent results related to 52 patients (66.7%), good in 15 (19.2%) and poor in 11 (14.1%). The squeeze pressure improved more significantly in men 33±11 cm H2O vs. 22±14 cm H2O; p=0.039. In patients <50 year squeeze pressure was significantly larger 32±10 cm H2O vs. 25±12 cm H2O; p=0.045. If the width of a defect within sphincter was less than 60°飀 the improvement in squeeze pressure was higher 33±9 cm H2O vs. 22±15 cm H2O; p=0.031. In Wexner scale male patients better responded to surgery than females 6.94±1.8 vs. 5.12±2.2, p=0.048; as well as patients with smaller scar <60° 6.51±1.4 vs. 4.28±2.3; p=0.042. Conclusions. To succeed in sphincteroplasty the proper qualification to the procedure should be crucial. Clinical assessment prior to surgery with the use of all available non-surgical methods in patients suffer from severe symptoms can help to select optimal group who will benefit from surgery. Male patients may have to obtain better outcome and patients with smaller sphincter defect could likely have also better results from surgery.
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The Association of Polish Surgeons on Pancreatic Fistulas

76%
Jabłońska B., Lampe P., Dziki A., Matyja A., Śledziński Z., Wallner G.
Polish Journal of Surgery
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2015
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vol. 86
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issue 5
244-247
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Does the Choice of Hospital Increase a Chance of Survival in Rectal Cancer?

76%
Pawlak M., Morawiec Z., Dziki Ł., Morawiec J., Kolacińska A., Dziki A.
Polish Journal of Surgery
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2012
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vol. 84
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issue 12
638-645
EN
was to assess the impact of hospital caseload on long-term outcomes of rectal cancer patients. We posed two questions: 1. Does the number of operations carried out in the surgical department influence five year survival and local recurrence rates? 2. Does surgery alone without adjuvant therapy performed in the particular department affect long-term results? Material and methods. 215 consecutive rectal cancer patients treated in six hospitals of the Łódź district between 1994 and 1998 were enrolled into this prospective study. We analyzed patients in whom local excision, low anterior resection, abdominoperineal resection and Hartmann’s procedure were performed. 27 percent of patients received adjuvant therapy such as radio- or chemotherapy or both. Long-term results were compared between high and low volume institutions by means of local recurrence and five year survival rates. Results. In high volume departments; 69.2% of five year survival rates were obtained versus 46.6% for low volume institutions (p=0.00433). Similar differences were noted comparing local recurrence rates between the aforementioned groups: 19.7% versus 36.5%, respectively (p=0.00430). In surgically treated patients who did not receive adjuvant therapy statistically significant differences were found: 76.5% of patients operated on in high volume hospitals survived five years as compared with 42.9% for low caseload institutions (p=0.00013). Local recurrence rates were 15.5% for high caseload institutions and 38.5% for low caseload hospitals (p=0.00042). Conclusions. High volume hospitals achieved better results in rectal cancer patients with regard to five year survival and local recurrence rates. Better outcomes were also obtained in high caseload departments regarding surgically treated patients who did not receive adjuvant therapy.
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